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Crime Victims Application for Benefits - Injury Claims
Authorization to Release Confidential Information. NOTE: The victim or legal guardian must sign this form to be valid. I hereby authorize any hospital
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Consent to Release Confidential Information
In signing this form, the individual releases the George Washington University, its officers, trustees, employees and agents, of any liability for the use,
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Confidential Information (CIF)
State agencies may disclose the information in this form according to their own rules. 1. Who is completing this form? (Name):. 2. Is there a current
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